Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) is a sudden acute and debilitating onset of neuropsychiatric symptoms in children that may include intense anxiety and mood lability. The child may exhibit obsessions and/or compulsions, motor and/or verbal tics, sensory sensitivities, sleeping difficulties, and restrictive eating. Children may also become moody or irritable, experience anxiety attacks, or have difficulty separating from parents or loved ones. The onset is sudden and dramatic with symptoms appearing to come “out of the blue.” The cause of PANS is often unknown but is thought to be triggered by infections and other inflammatory reactions.
Similar to PANS, children with Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS) have an acute onset of neuropsychiatric symptoms, most typically OCD and/or tics. However, children with PANDAS test positive for a recent streptococcal infection, such as strep throat or scarlet fever. The sudden and debilitating onset of intense anxiety and mood lability is associated with a streptococcal infection that has occurred immediately prior to the symptoms. In some instances, the onset can be 4 to 6 months after a strep infection because the antibiotics did not fully eradicate the bacteria. PANDAS occurs when strep triggers a misdirected immune response and results in inflammation.
It is estimated that PANDAS/PANS affects as many as 1 in 200 children. PANDAS typically first appears in childhood from age 3 to puberty. Reactions to strep infections are rare after age 12, but could occur among adolescents. It is thought to be unlikely that an adult would begin to experience these symptoms for the first time as an adult, but more research is needed in this area.